Understanding Head CT Scan Usage Amongst Adolescent Blunt Trauma Patients Treated at a Level 1 Adult Trauma Center.

Autor:	Parker LA; Department of Surgery, Morehouse School of Medicine, Atlanta, GA, USA., Villamor LL; Department of Surgery, Morehouse School of Medicine, Atlanta, GA, USA., Groszman L; Department of Surgery, Morehouse School of Medicine, Atlanta, GA, USA., Xiang L; Center for Data Science, New York University, New York, NY, USA., Koganti D; Department of Surgery, Emory University, Atlanta, GA, USA., Smith R; Department of Surgery, Emory University, Atlanta, GA, USA., Sola R Jr; Department of Surgery, Morehouse School of Medicine, Atlanta, GA, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2023 Jul; Vol. 89 (7), pp. 3187-3191. Date of Electronic Publication: 2023 Feb 17.
DOI:	10.1177/00031348231157806
Abstrakt:	Background: Guidelines developed by the Pediatric Emergency Care Applied Research Network (PECARN) exist to reserve the use of head CT for pediatric patients with a high risk of head injury. However, CTs are still being overutilized especially at adult trauma centers. The aim of our study was to review our use of head CTs in adolescent blunt trauma patients. Materials and Methods: Patients aged 11-18 who underwent head CT scans from 2016 to 2019 at our urban level 1 adult trauma center were included. Data was collected via electronic medical record and analyzed through retrospective chart review. Results: Of the 285 patients requiring a head CT, 205 had a negative head CT (NHCT) and 80 patients had a positive head CT (PHCT). There was no difference in age, gender, race, and trauma mechanism between the groups. The PHCT group was found to be with a statistically significant higher likelihood of the Glasgow Coma Scale (GCS) < 15 (65% vs 23%; P < .01), abnormal head exam (70% vs 25%; P < .01), and loss of consciousness (85% vs 54%; P < .01) compared to the NHCT group. There were 44 patients who had low risk of head injury, based on the PECARN guidelines, and received a head CT. None of the patients had a positive head CT. Conclusion: Our study suggests that reinforcement of the PECARN guidelines should occur for ordering head CTs in adolescent blunt trauma patients. Future prospective studies are needed to validate the use of PECARN head CT guidelines in this patient population.
Databáze:	MEDLINE
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